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ICD-10 Guide
ICD-10 CodesChapter 9: Diseases of the circulatory systemI25

I25

Non-billable

Chronic ischemic heart disease

Chapter 9:Diseases of the circulatory system

BILLABLE STATUSNo
IMPLEMENTATION DATEOctober 1, 2015
LAST UPDATED09/06/2025

Code Description

ICD-10 I25 is a used to indicate a diagnosis of chronic ischemic heart disease.

Key Diagnostic Point:

Chronic ischemic heart disease (I25) encompasses a range of heart conditions characterized by reduced blood flow to the heart muscle due to narrowed or blocked coronary arteries. This condition often presents with symptoms such as angina pectoris, shortness of breath, and fatigue, particularly during physical exertion or stress. The anatomy involved includes the coronary arteries, which supply blood to the heart muscle, and any obstruction can lead to myocardial ischemia. Disease progression may vary, with some patients experiencing stable angina while others may develop acute coronary syndromes. Diagnostic considerations include a thorough patient history, physical examination, and diagnostic tests such as electrocardiograms (ECGs), stress tests, and coronary angiography to assess the severity of arterial blockages. Management typically involves lifestyle modifications, pharmacotherapy (e.g., antiplatelet agents, beta-blockers), and potentially revascularization procedures like angioplasty or coronary artery bypass grafting (CABG).

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Diagnostic complexity: Requires comprehensive assessment of symptoms and risk factors.
  • Treatment complexity: Involves a multi-faceted approach including lifestyle changes and possible surgical interventions.
  • Documentation requirements: Detailed documentation of clinical findings, treatment plans, and patient responses is essential.
  • Coding specificity: Requires accurate coding to reflect the specific type of ischemic heart disease.

Audit Risk Factors

  • Common coding errors: Misclassification of acute vs. chronic conditions.
  • Documentation gaps: Incomplete records of patient history or treatment plans.
  • Billing challenges: Denials related to insufficient documentation or lack of medical necessity.

Specialty Focus

Medical Specialties

Cardiology

Documentation Requirements

Standard ICD-10-CM documentation requirements apply

Common Clinical Scenarios

Various clinical presentations within this specialty area

Billing Considerations

Follow specialty-specific billing guidelines

Internal Medicine

Documentation Requirements

Standard ICD-10-CM documentation requirements apply

Common Clinical Scenarios

Various clinical presentations within this specialty area

Billing Considerations

Follow specialty-specific billing guidelines

Related CPT Codes

CPT Code

Clinical Scenario

Documentation Requirements

CPT Code

Clinical Scenario

Documentation Requirements

CPT Code

Clinical Scenario

Documentation Requirements

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

Chronic ischemic heart disease significantly impacts population health, contributing to high morbidity and mortality rates. It is a leading cause of hospitalizations and healthcare utilization, necessitating effective management strategies. Quality measures often focus on controlling risk factors such as hypertension and diabetes, as well as ensuring appropriate follow-up care. Epidemiologically, the prevalence of ischemic heart disease is influenced by lifestyle factors, making public health initiatives aimed at prevention and education critical.

ICD-9 vs ICD-10

Chronic ischemic heart disease significantly impacts population health, contributing to high morbidity and mortality rates. It is a leading cause of hospitalizations and healthcare utilization, necessitating effective management strategies. Quality measures often focus on controlling risk factors such as hypertension and diabetes, as well as ensuring appropriate follow-up care. Epidemiologically, the prevalence of ischemic heart disease is influenced by lifestyle factors, making public health initiatives aimed at prevention and education critical.

Reimbursement & Billing Impact

Reimbursement considerations include the necessity of demonstrating medical necessity for tests and procedures. Common denials may arise from insufficient documentation or failure to meet payer-specific guidelines. Best practices include maintaining thorough records of patient interactions, treatment responses, and follow-up care to support claims and reduce audit risks.

Resources

Clinical References

  • •
    ICD-10 Official Guidelines for I00-I99
  • •
    Clinical Documentation Requirements

Coding & Billing References

  • •
    ICD-10 Official Guidelines for I00-I99
  • •
    Clinical Documentation Requirements

Frequently Asked Questions

What specific conditions are covered by I25?

I25 covers chronic ischemic heart disease, including stable angina, unstable angina, and myocardial infarction due to ischemic heart disease. It may also include conditions such as coronary artery disease and heart failure resulting from chronic ischemia.

When should I25 be used instead of related codes?

I25 should be used when the patient has a documented history of chronic ischemic heart disease, particularly when symptoms are stable and there is evidence of coronary artery disease. It is distinct from acute conditions coded under I20 or I21.

What documentation supports I25?

Documentation should include a detailed patient history, results from diagnostic tests (e.g., ECG, stress tests), treatment plans, and any referrals to specialists. Evidence of chronicity and management strategies should be clearly outlined.